Provider Demographics
NPI:1265665954
Name:NORTHPOINTE COUNCIL INC
Entity Type:Organization
Organization Name:NORTHPOINTE COUNCIL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHUBADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-282-1228
Mailing Address - Street 1:800 MAIN STREET
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:NIAGRA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301
Mailing Address - Country:US
Mailing Address - Phone:716-282-1228
Mailing Address - Fax:716-282-1238
Practice Address - Street 1:1001 11TH STREET
Practice Address - Street 2:
Practice Address - City:NIAGRA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301
Practice Address - Country:US
Practice Address - Phone:716-278-8110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00932467Medicaid